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Week 7 NCO
Week 7 NCO Administering Enternal Nutrition
| Question | Answer |
|---|---|
| A patient has a medical history of cerebrovascular accident with impaired swallowing, stomach cancer with gastric resection, anemia, and hypertension. What route of feeding would you expect the patient to have? | Ni |
| You are preparing to administer an intermittent tube feeding. For effective time management, you enlist the help of NAP. What instructions should you give the NAP to complete this task? | 1. To place the patient in an upright position 2. Allow the feeding to infuse per ordered rate 3. Report any difficulty with the feeding infusion 4. To report any distress experienced by the patient immediately |
| Nursing Assessment 1. Absence of drug or food allergies 2. Patient has impaired swallowing with history of 3. Auscultation reveals bowel sounds in all four 4. Jevity formula feeding to infuse at 50 mL 5. Serum albumin 3.0 and lymphocytes 1700 m | 1.Prevents patient from developing localized reactions 2. Verifies patients need for enternal feedings 3. Absent bowel sounds would mean the patient is unable to 4. Verifies health care providers orders 5. Identifies signs of malnutrition |
| Image A - Image B- Image C- Image D - Image E - Image F You are preparing to administer a continuous tube feeding. Which of the following would be appropriate for carrying out this procedure? (Select all that apply.) | Image B, C, D (putting gloves on, testing and syringe) |
| You are planning care for a patient with an enteral feeding tube. Which of the following are appropriate expected outcomes? (Select all that apply.) | 1. Patient does not have any signs of respiratory distress. 2. Underweight patient's weight increases. 3. Laboratory values are within normal limits by discharge. 4. Patient verbalizes an absence of abdominal discomfort. |
| You aspirate gastric contents to check the residual volume. Fifty milliliters are obtained. You return the gastric contents to the patient's stomach. The patient asks you why you did this. Your best response is: | "Returning the aspirate prevents fluid and electrolyte imbalance." |
| The health care provider's orders say to advance the intermittent tube feedings to 240 mL every 4 hours "as tolerated." Which of the following findings by you, the nurse, demonstrate that the tube feedings are being "tolerated" to increase the rate of inf | 1. Gastric residual of 30 mL 2. Absence of nausea 3. Absence of diarrhea |
| For continuous enteral feeding, the maximum amount of time formula should remain hanging is ________ hours in an open system. | 12 |
| Which of the following is the most accurate documentation of the administration of an enteral feeding? | Farrell record |
| When initiating enteral tube feedings, you should weigh the patient weekly. | False |
| To determine the patient's tolerance of feedings, you should check the patient's urine output every 6 hours until maximum administration rate is achieved for 24 hours. | False |
| Evaluation of tube feedings should include monitoring and recording residual volumes, monitoring the patient's respiratory status, and asking the patient if abdominal cramping or nausea is experienced during or after feedings. | True |
| Because the patient has a continuous tube feeding, when should gastric residual volume be checked? | Every 4-6 hours |
| A patient is receiving a continuous enteral feeding by infusion pump. The nurse enters the patient's room to verify tube placement and measure residual. The nurse notices the patient's respirations are shallow and rapid and that the patient's color is ash | 1. Position patient on side. 2. Turn off the tube feeding. 3. Suction the patient. 4. Notify the health care provider. |
| The nurse is going to irrigate the patient's established feeding tube with 30 mL of tap water before instilling the tube feeding. The nurse attempts to do so without success. What should action should the nurse take? | Reposition the patient. |
| The nurse is going to administer a bolus enteral tube feeding of 240 mL. The nurse has obtained a pH of 4 and 50 mL of gastric aspirate. Based on these findings, what action should the nurse take? | Return the aspirate to the patient’s stomach and administer the feeding. |
| The nurse is going to administer an intermittent tube feeding. Because the patient's feeding tube has been in place for 3 days, which action is best for the nurse to take at this time? | Aspirate gastric contents and test on a pH strip. |
| The patient is presently receiving intermittent tube feedings of 120 mL every 6 hours. The health care provider's orders state: Jevity formula feeding 240 mL every 6 hours per feeding tube, increase per patient tolerance. Which of the following assessment | 1. Diarrhea. Correct 2. Abdominal distention and discomfort. Correct 3. Nausea. Correct 4. Residual volume greater than 500 mL. |
| The patient is receiving a continuous enteral feeding. Which of the following assessment findings would require follow-up? | Gastric residual of 375 mL. |
| Which of the following is an appropriate nursing action to prevent a complication of nasogastric (NG) tube feedings? | Keep the head of the patient’s bed elevated at least 30 degrees. |
| Why is it important to have the tube feeding at room temperature? | Cold formula can cause gastric cramping. |
Created by:
Brandi Sizemore
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